The purpose of this study was to determine the prevalence of trachoma in evaluation units (EUs) of grouped districts (woredas) in Benishangul Gumuz region, Ethiopia. A population-based prevalence survey was conducted in 2013-2014 in each EU according to the methodology of the Global Trachoma Mapping Project. The study concluded that four of the seven EUs require implementation of the A, F and E components of the SAFE strategy (surgery, antibiotics, facial cleanliness and environmental improvement). All seven EUs had trichiasis prevalence in adults significantly over the 0.2% WHO threshold for trachoma elimination: therein calling for considerable investment to recruit and train eye care workers.